May 17, 1948
Dear Dr. Jeghers,
I certainly enjoyed the weekend in Washington two weeks ago. Here is the material I have accumulated since then:
(1) The reference for Siemens' term for these spots, "ephelides inversae", is H. W. Siemens, "Vererbungspathologie Pigmentosen", Jadassohn's Handbuch, v. III, p. 99.
(2) Enclosed is written permission from the mother of [NAME REDACTED], the colored boy, for publication of his photographs. I  have not yet heard from the S. Carolina girl but will forward her permission to you as soon as I get it. (The enclosed letter came from the parents of the So. Carolina girl after I wrote this. As you see they are unwilling for full photographs to be published.)
(3) Enclosed are three reproductions. One of them is one of Peutz' cases and shows both the spots and the polyps. You already have the reference to Peutz' article. The other prints are of a case in the following reference: Siemens, H. W., "Zur klinsch-atiologischen Analyse and Systematik kleinfleckiger Pigmentierungen, nebst Beshreiben einer besonderen Form von Epheliden," Dermatologische Zeitschrift LIII: 575-591, 1928. This case showed freckle-like spots in the usual places but in addition had numerous spots on the oral mucosa and on the palms. No reference is made to the patient having any internal medicine condition.
(4) Dr. J. L. A. Peutz, physician-in chief at the Roman Catholic Hospital in the Hague, is probably still living. Through the 1920's and the 1930's almost every volume of the Cumulative Index carries some reference to him. He wrote on a great variety of subjects -- refractory anemias, tests of liver function, carcinoma of the lung, etc. -- but I could find no reference to his 1921 article on the syndrome and could not find that he has made any other publication on this subject. The last reference to Peutz is in the Cumulative Index of 1939. None of the Dutchmen around here know him. At any rate I have sent an airmail letter to him asking him if he knows anything more about this subject than he includes in his 1921 article.
(5) We have reviewed Peutz' article in an attempt to get enough information to complete the charts for his cases. We find that in his article of 1921 he does not give enough data on 3 or 4 of the cases to allow us to do so. In the 1933 edition of Jadassohn, on the other hand, there is reference to other members of the family having the syndrome, making a total of 5 cases. It must be that Meirowsky got additional data direct from Peutz. At any rate the data at hand is not complete enough for charts.
(6) The usage here is: "From the Medical Clinic, the School of Medicine, Johns Hopkins University and Hospital, Baltimore, Md."
(7) If you decide definitely on included colored plates would you let me know and I will speak to Dr. Harvey about contributing to the expense. I certainly think including the maximum number of black-and-whites is highly desireable [sic].
Thanks again for putting me up the other weekend.
Sincerely,
Victor A. McKusick